This report is issued by the Administrator of the National Health Funding Pool under section 240 of the National Health Reform Act 2011.

This report is prepared on a cash basis. It shows monthly and year-to-date (YTD) National Health Reform (NHR) funding and payments for the Northern Territory for April 2013 as part of the National Health Reform Agreement.

Participation in the National Health Funding Pool – Northern Territory, April 2013

In signing the National Health Reform Agreement (the Agreement), it was the intention of all states and territories that they would have the necessary legislation in place to enable them to participate in the National Health Funding Pool from 1 July 2012.

However, not all states and territories had their legislation in place by that date. As part of the transition to National Health Reform funding, arrangements were put in place whereby those states and territories received equivalent funding directly from the Commonwealth Treasury, and made payments directly from departmental bank accounts to local hospital networks (LHNs). Although these transactions were not made through state pool accounts and state managed funds, they have been included in this report (and designated as ‘notional payments’ into and out of state pool accounts and state managed funds) to enable national comparability for month and year-to-date reporting periods.

The Northern Territory has participated in the National Health Funding Pool since 1 October 2012.

Local hospital networks and National Health Reform

A local hospital network (LHN) is an organisation that provides public hospital services in accordance with the Agreement. A local hospital network can contain one or more hospitals, and is usually defined as a business group, geographical area or community. Every Australian public hospital is part of a local hospital network.

Note: The term ‘local hospital network’ is a national term. Some states and territories use their own terminology to describe these networks, such as local health districts, health organisations, and hospital and health services.

Under the Agreement, local hospital networks receive funding for the following public hospital services:

All admitted and non-admitted services

All emergency department services provided by a recognised emergency department

Other outpatient, mental health, sub-acute services and other services that could reasonably be considered a public hospital service.

Note: Local hospital networks also receive funding from other sources, including the Commonwealth, states and territories, and third parties for the provision of other specific functions and services outside the scope of the Agreement, for example dental services, primary care, home and community care, residential aged care and pharmaceuticals. For further information on total funding to a particular local hospital network, contact the NT Department of Health to view the service agreement for that local hospital network.

The basis used to determine NHR payments to local hospital networks (LHNs) in the Northern Territory for April 2013 was advised by the NT Department of Health to be as follows:

The annual funding allocation for the Top End and Central Australian Hospital Networks of Northern Territory has been determined on a historical basis for both the activity-based funding (ABF) and block service streams, supplemented by a level of growth based on Northern Territory Government Wage and Consumer Price Index parameters. Projected activity increases are not budgeted for and both local hospital networks are required to meet demand increases from within existing resources as a cost containment strategy.

Variations to monthly payments to the Northern Territory local hospital networks (LHNs) are made based on cash requirements. Cash requirements are impacted by the Northern Territory Salary payment cycle and other monthly variations, such as contractual obligation payment cycles which the local hospital networks are engaged in. The local hospital networks in the Northern Territory have been in a transitional phase and payments during this period have varied based on costs held centrally being transitionally transferred over.

Reference information

The financial information outlined in the following report is categorised as:

NHR funding – when the Commonwealth or state or territory government pays NHR funding into a state pool account or state managed fund.

NHR payments – when NHR funding deposited into a state pool account or state managed fund is paid out of the state pool account by the Administrator, or is paid out of the state managed fund by the state or territory.

Notional NHR payments – funds paid into and out of departmental bank accounts to local hospital networks that would have been transacted through the state pool account and/or state managed fund had NHR funding arrangements been in place. Notional payments are included in 2012-13 reporting to enable national comparability for month and year-to-date reporting periods.

State pool account transactions

This table shows funding paid into the Northern Territory state pool account by the Commonwealth and the Northern Territory, and payments out of the state pool account to local hospital networks, the state managed fund, and the NT Department of Health for April 2013.

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the Northern Territory state pool account by the Commonwealth and the Northern Territory, and YTD payments out of the state pool account to local hospital networks, the state managed fund, and the NT Department of Health as at April 2013.
These amounts include notional payments for July, August and September 2012.

Note: Of the total year-to-date amount of $336,835,538 shown in Table 1b as paid into the Northern Territory state pool account, $86,735,104 was notional year-to-date payments.
Of the total year-to-date amount of $336,823,707 shown in Table 1b as paid out of the Northern Territory state pool account, $86,735,104 was notional year-to-date payments.
No payments were made from the Northern Territory state pool account in July, August and September 2012, with payments made directly from departmental bank accounts to local hospital networks.

Commonwealth ABF funding represents Acute admitted public, Acute admitted private, Non-admitted, and Emergency department service categories, which are funded by the Commonwealth through the state pool account and subsequently paid to local hospital networks.

Commonwealth Block funding represents Mental health, Small rural and metropolitan hospitals, Sub-acute, Teaching, training and research, and Other categories, which are funded by the Commonwealth and paid to the state managed fund.

Commonwealth Other funding represents other amounts funded by the Commonwealth, transacted through the state pool account and subsequently paid to state or territory health departments. This currently represents the Commonwealth contribution to public health.

State/territory funding represents funding contributions paid by the Northern Territory into its own state pool account, and subsequently paid to local hospital networks within the state and/or to state or territory health departments.

Note: The grey shaded areas in these tables reflect that these amounts are not applicable for a particular 'paid out' column. For example, Commonwealth block funding is only paid to state managed funds and is not applicable for local hospital networks or state or territory health departments.

NHR funding and payments shown in these tables include GST where applicable.

State managed fund transactions

This table shows funding paid into the Northern Territory state managed fund by the Commonwealth and the Northern Territory, and payments out of the state managed fund to local hospital networks and other provider organisations for April 2013.

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the Northern Territory state managed fund by the Commonwealth and the Northern Territory, and YTD payments out of the state managed fund as at April 2013. These amounts include notional payments for July, August and September 2012.

Commonwealth Block funding represents Commonwealth block funding contributions paid into the state managed fund from the state pool account, and block payments out of the state managed fund to local hospital networks and other provider organisations.

State/territory Block funding represents Northern Territory block funding contributions into the state managed fund, and block payments out of the state managed fund to local hospital networks and other provider organisations.

Note: The grey shaded areas in these tables reflect that these block payments cannot at this stage be identified by source of funding (state, territory or Commonwealth contribution).

NHR funding and payments shown in these tables include GST where applicable.

NHR funding and payments by service category

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for the Northern Territory for April 2013. NHR funding and payments are separated into the following service categories – activity-based funding (ABF), block funding, and other funding.

Total ABF (Pool) is an aggregate of both Commonwealth and state or territory NHR funding and payments for activity-based funding (ABF) which is transacted through the state pool account.

Total Block (SMF) is an aggregate of both Commonwealth and state or territory NHR funding and payments for block funding which is transacted through the state managed fund (SMF).

Total Other (Pool) represents other funding and payments, which are transacted through the state pool account, including public health funding, overdeposits, cross-border funding and payments, and interest. State and territory cross-border payments can either be:

Paid to the relevant state or territory's local hospital networks - included within ABF and/or block payments in the above table, or

Reimbursed to the relevant state or territory where the state or territory's local hospital networks are already being funded for the cost of treating cross-border patients - shown in the Cross-border row under Other in the above table.

Cross-border funding arrangements between states and territories are yet to be put in place for state and territory contributions.

NHR funding and payments shown in these tables include GST where applicable.

A local hospital network (LHN) is an organisation that provides public hospital services in accordance with the National Health Reform Agreement. A local hospital network can contain one or more hospitals, and is usually defined as a business group, geographical area or community. Every Australian public hospital is part of a local hospital network.

NHR payments in this table are GST exclusive to enable comparability of NHR payments in each local hospital network report.

Note: This table excludes GST and payments to other provider organisations (non-local hospital networks). The majority of government funding to local hospital networks is not subject to GST. However in some cases hospital funding to non-government entities does attract GST, for example, denominational hospitals, privately and commercially owned health facilities, or any other non-government third party provider of health services or related supplies.

Estimated monthly, YTD and annual NWAU by local hospital network

States and territories provide NHR funding amounts and service volumes as service estimates at the start of each financial year, and if required, can continue to refine these estimates during the course of the year. These estimates form the basis of monthly reporting of service volumes until actual service numbers become available. These estimates are expressed as National Weighted Activity Units (NWAU).

States and territories provide estimated annual NWAU to the Administrator as a basis for determining the Commonwealth activity-based funding. Current month NWAU estimates accumulate through the year-to-date (YTD) NWAU, to be equal to the annual NWAU at the end of the financial year.

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for April 2013, the associated cumulative year-to-date (YTD), and total estimated annual NWAU for each local hospital network in the Northern Territory.

An NWAU is a measure of health service activity expressed as a common unit. It provides a way of comparing and valuing each public hospital service, whether they are admissions, emergency department presentations or outpatient episodes, by weighting them for their clinical complexity. The average hospital service is worth one NWAU - the most intensive and expensive activities are worth multiple NWAU, the simplest and least expensive are worth fractions of an NWAU.

Monthly NHR payments relate to the cash needs of public hospitals and do not necessarily reflect the volume of services to be delivered in the month.